A patient is taking an oral anticoagulant for a deep vein thrombosis. Which symptom would the nurse educate the patient to report immediately?
Elevated hematocrit
Dizziness
Blood pressure 150/88
Bleeding profusely
The Correct Answer is D
A. Elevated hematocrit: An elevated hematocrit reflects increased red blood cell concentration and may be associated with dehydration or polycythemia, but it is not a typical complication of oral anticoagulant therapy. Anticoagulants increase bleeding risk rather than causing hemoconcentration.
B. Dizziness: Dizziness can have multiple etiologies, including orthostatic hypotension, anemia, or medication effects. While it may warrant evaluation, it is nonspecific and not necessarily an immediate sign of anticoagulant-related complications. It becomes more concerning if associated with signs of significant blood loss or hemodynamic instability.
C. Blood pressure 150/88: A blood pressure of 150/88 mmHg is elevated but does not constitute a hypertensive emergency. Although uncontrolled hypertension can increase the risk of hemorrhagic complications in anticoagulated patients, this value alone does not require immediate emergency reporting unless accompanied by neurological symptoms.
D. Bleeding profusely: Profuse bleeding is a critical complication of oral anticoagulant therapy, as these medications impair clot formation by inhibiting vitamin K–dependent clotting factors or thrombin activity. Uncontrolled bleeding can rapidly lead to hypovolemia, shock, or intracranial hemorrhage. Immediate medical attention is necessary to assess coagulation status and administer reversal agents if indicated.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Administer small increments of IVP medication over 5 minutes, flush with normal saline: Digoxin IV push must be administered slowly, typically over at least 5 minutes, to reduce the risk of severe bradycardia, hypotension, or cardiac arrhythmias. Administering in small increments allows careful monitoring of the patient’s cardiac response. Flushing with normal saline before and after ensures the full dose is delivered and prevents drug interaction.
B. Inject IVP medication into a primary IV bag and infuse over 5 minutes: Mixing digoxin directly into a primary IV fluid is not recommended because compatibility issues may occur, and the exact dose delivered can be difficult to control. IV push through a controlled line ensures accurate dosing and safety.
C. Flush with normal saline over 5 minutes, administer IVP medication: Flushing before administering digoxin is unnecessary unless verifying line patency. Administering the flush first alone does not prevent complications if the drug is injected too rapidly; careful, slow IV push of the digoxin itself is the critical safety measure.
D. Administer IVP medication, wait 5 minutes, flush with normal saline: Waiting after IV push without flushing may leave residual medication in the line, leading to incomplete dosing. Flushing immediately after administration ensures the patient receives the full prescribed dose safely and reduces risk of line incompatibility.
Correct Answer is ["0.7"]
Explanation
Calculation:
Bolus Dose: 50 units/kg
Patient Weight: 70 kg
Dose in units = 50 × 70
= 3500 units
- Identify the available concentration
Available: 5000 units/mL
- Calculate the volume to administer
Volume to administer = Ordered Dose ÷ Concentration
Volume to administer = 3500 ÷ 5000
= 0.7 mL
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